A review of 55 separate studies of sex and relationships education (SRE) in schools shows that young people have many criticisms of its narrow approach and its delivery by poorly trained, embarrassed teachers. Classes focus on avoiding unwanted pregnancy and sexually transmitted infections, but give little attention to the needs of lesbian, gay, bisexual and transgender (LGBT) pupils.
“SRE should be ‘sex-positive’ and delivered by experts who maintain clear boundaries with students,” the researchers write in BMJ Open. “Schools should acknowledge that sex is a special subject with unique challenges, as well as the fact and range of young people's sexual activity, otherwise young people will continue to disengage from SRE.”
Background
In England, local-authority run state schools must teach anatomy, puberty, the biological aspects of sexual reproduction, sexually transmitted infections (STIs) and HIV/AIDS. Schools are not obliged to teach any other aspects of sex and relationships education. Moreover, academies, free schools and private schools are not obliged to provide any SRE at all.
Requirements differ in Wales and Northern Ireland. In Scotland, schools are not obliged to provide any SRE at all.
The quality of SRE is thought to vary widely. Quantitative studies conducted with young people indicate that SRE starts too late, is too biological, doesn’t cover all relevant issues, has a negative tone and is poorly delivered.
The Terrence Higgins Trust, NAT (National AIDS Trust) and Sex Education Forum are campaigning for SRE to be made compulsory in all schools and for it to address the needs of LGBT pupils.
In order to understand the issue in more depth, researchers from the University of Bristol identified previously published qualitative studies of young people’s views about the SRE they had received. The researchers used techniques of meta-ethnography and thematic analysis to bring together and synthesise the findings from the original studies.
Most studies were of school-based SRE delivered to secondary school pupils by teachers. Just under half the studies were from the United Kingdom, with most of the others from English-speaking countries in North America or Australasia. In most of the studies, young people took part in focus groups.
Sex as a distinctive issue
An over-arching theme was that schools have taken insufficient notice of the distinctive nature of sex as a topic. Sex is a potent subject that can arouse strong emotions and reactions, but schools seem to deny that there is anything exceptional about the topic. They attempt to teach SRE in the same way as other scientific subjects.
Students reported embarrassment and discomfort, particularly in mixed-sex classes. While young men are expected to be sexually knowledgeable, they were afraid of revealing themselves as sexually inexperienced by asking a question, as this pupil explained:
“Some people are too scared to say things so they cover that up by being noisy and disrupt the class.”
Young women often took SRE classes seriously but in mixed classes, male pupils sometimes discouraged their participation by verbally harassing them. Teachers often failed to confront young men about this kind of behaviour.
Young people wanted to receive SRE in a safe and confidential environment that would allow them to participate without inhibition. Those teachers who were able to maintain control of the class and protect students from ridicule helped pupils engage with the subject. Setting ground rules for discussion, behaviour and confidentiality was seen to be helpful.
Young people criticised SRE for being overly biological, judging the approach to be basic, repetitive, narrow and irrelevant. A Canadian pupil said:
“Everything we got in our class had a really clinical feel, it's just like information but it's not related to yourself”.
SRE was also seen to try to contain sexuality within an implicit moral framework. Young people noted a focus on unwanted pregnancy, STIs and the casting of young men as sexual predators. Young people’s sexuality was seen as a ‘problem’ to be managed.
“All they ever do is talk about the dangers of sex and that, and nothing about the pleasure.”
A common theme in studies was that homosexuality was barely mentioned, making lesbian, gay, bisexual and transgendered students invisible. Young people wanted homosexuality to be discussed within SRE, to help normalise same-sex relationships, address homophobia and support young LGBT people.
Out of touch with pupils’ lives
Schools appear to struggle to accept that some young people are sexually active. This leads to SRE content that is out of touch with many student's lives. Many young people reported that SRE was provided too late, when they were already having sex.
With SRE narrowly focused on heterosexual intercourse, young people said that it didn’t acknowledge the full range of sexual activities they engaged in – many of which would actually be counted as ‘safer sex’. A pupil in Northern Ireland said:
“So you just were taught about sexual intercourse causing pregnancy, but you were never taught about masturbation; you were never taught about oral sex all the different, other types of sexual practices…”
Young people wanted classes to talk more about what sex involves and how to have sex. Many young men were anxious about being able to ‘perform’ and particularly wanted this information. As it wasn’t provided, many turned to pornography instead.
Many wanted to know how to make sex pleasurable but this wasn’t discussed. Female pleasure was particularly absent from SRE, reproducing stereotypes of women as passive and lacking in desire. Young women also wanted to talk about emotions and relationships.
“They don't really go into the whole relationships thing partly because I don't think—they don't want us to have relationships”.
“They didn't talk about the emotional part of having sex. They didn't really talk about how sex will affect you as a person and how it affects your emotions.”
Since schools have difficulty accepting young people's sexuality, SRE failed to discuss some issues that were relevant to sexually active young people – the health services they can use, their options available if pregnancy occurred, and the pros and cons of different contraceptive methods.
Who should provide SRE?
Teachers were commonly reported to be embarrassed and awkward when delivering SRE. Students reported that teachers seemed unable to discuss sex frankly and responded unsatisfactorily to questions. Teachers were thought to be poorly trained on the issue.
“If your teacher who's a grown up can't talk about it, how are you [supposed to]? That gives you the impression that, oh I'm not really supposed to talk about it.”
While it’s often thought that teachers are well-placed to deliver SRE because they know their students, it was this familiarity that many students found inappropriate. It disrupted existing relationships and breached boundaries – it was embarrassing to discuss sexual matters with teachers they would interact with again in the future.
The power imbalance between pupils and teachers also inhibited discussion.
When SRE had been delivered by peer educators, students reported more egalitarian and mutually respectful relationships. They felt a sense of affinity with the peer educators, which encouraged them to believe the information they provided. Young people appreciated the techniques they used to create a safe environment and their use of discussion-based approaches.
Many young people liked the idea of sexual health professionals delivering SRE. They were perceived to be less judgemental and better informed than teachers. As with peer educators, their lack of experience in maintaining classroom discipline could sometimes be a problem. But both peer educators and sexual health professionals had the advantage of not having an ongoing relationship with pupils.
“You want someone who's not from the school or someone who actually does it as a job and knows what they're talking about and you know can be professional about what they are telling you.”
Conclusion
“Young people's aspirations for SRE appear to align with a ‘sex-positive’ approach that aims for young people to enjoy their sexuality in a way that is safe, consensual and healthy,” the researchers say.
They say it is also important to identify the right educators to deliver SRE. While this review of studies highlights considerable problems with using teachers, the researchers acknowledge practical problems with having SRE delivered by non-teachers. Outside experts are expensive, while peer educators have to be regularly trained as existing cohorts get older. Teachers are seen as a more sustainable option.
The researchers suggest a compromise – specialist SRE teachers who only teach SRE and whom students would not encounter in other contexts. This could address pupils’ need for clear boundaries and for skilled providers.
Pound P et al. What do young people think about their school-based sex and relationship education? A qualitative synthesis of young people's views and experiences. BMJ Open 6:e011329, 2016. (Full text freely available online).